The interview with Patience Mthunzi-Kufa

Is it possible to refuse a bunch of pills and get laser treatment for HIV?

The answer to this question can be found in our interview with Patience Mthunzi-Kufa, Head of Biophotonics.

• Hi, Patience, it is nice to meet you. Before the interview, Medtop Award wrote an article about your biophotonics project, so thank you for this opportunity to discuss it personally. It is a sensitive issue, but as we know, initially, people with HIV had to take the pills internally like regular pills. However, the effectiveness of this method is less than the delivery of the drug to the target point. So you started studying biophotonics and laser for targeted drug delivery in latent viral sites. Maybe you can briefly explain how this technology works

• Okay. So Jean, thanks for the question. We are using laser technology or laser-based technology for drug delivery. Initially, we do is we infect cells in the laboratory. This procedure was mostly in vitro, which means it works in the test tube. After infection, we test for infectivity, of course, because we want to be sure that the sample we are working with does indeed have the virus. So once we know that the cells are infected, we then use various means of actually trying to solve the infection. One would be to use the ARV themselves, including Verapin, depending on which of them are available in the lab. Finally, we use laser technology, precisely a helium-neon laser. It's the technology called low-level laser therapy. The next step is calculating laser energy and how much you want the cells to be exposed. I think we use from 2 to 10 joules per centimeter. We used a different range of energy to help determine the optimum value for the explosion. The optimum value for HIV types of samples is between six and eight Joules 10-centimeter squares. After the laser explosion, we incubated the cells to do the tech cytotoxicity and viability tests. So these cytotoxicity experiments tell us how many cells died from exposure to the laser. The viability experiments tell us how many cells became viable after laser treatment. Furthermore, it is essential to check holistically on the sample, whether everything is good with the sample or, rather, the sample is broken. The next step is checking for infectivity and to what extent laser explosion was effective in eradicating HIV. Afterward, we compared laser-exposed cells to the cells treated with RVs. The results show that the viability and cytotoxicity go down in both cases, but with the laser, it's controlled and more precise. Furthermore, with the laser technique, additional information can be gathered. So that's how we did the work. It's good enough that it works in vitro, in the test tube, but, you'd want to apply it in the human body because that's where HIV is. So what we then decided to do was follow two approaches. One was to either make a device that will be sent through optical fibers to the site where the cells are infected and laying dormant. And if we target those sites, you actually kill HIV before it comes out of those domain sites, all right. Alternatively, we can then make a device that will allow you to treat this HIV in the human body, it can be a chamber, or it can be in the form of a jacket or a leather jacket. Now we have options.

• It's a great idea. I don't even know how the person may imagine it. Tell us more, please. Does this method have a clinical trial seal?

• Of course, we would need to have clinical trials to integrate this method into the treatment of human bodies. We did laser-based drug delivery technology not for in vitro purposes but for integration into clinical trials.

• Thank you. Another question is what will be the economic component of the treatment of HIV infection by delivering drugs through a laser, and how accessible it might be?

• So of note, Jean, South Africa has a massive ARV program, and much of our government's money is spent on that. That's one of the things we are looking at to reduce the debt in terms of the finances, of paying for ARVS and buying ARV overseas. Currently, our government buys technology from abroad, but the integration of local technologies, as I presented, much economically beneficial. And because HIV has been a problem for many of our people, it would be good to have a solution. We are not saying we can heal it. But at least we can treat it to a stage that a patient can still live with, let's say, zero viral load level in the system. So those are all the tests we will still need to do to ensure that the technology achieves that. One other thing is that with laser technologies, it's not complicated to make them cheap and easily accessible right at the point of care or wherever the patient is. So that would be an added benefit as well. If we've got these devices, let's say in urban or rural areas in South Africa, they can be used by anybody who needs them.

• Yeah, for me, it sounds great. And even the business model, which includes the production cost, may be cheaper, and it is awesome. However, as we know there is always another side of a coin that exists. In this regard, did the delivery of drugs with the laser have any criticism among the medical community?

• Of course, anything new is prone to either being uptaken with a lot of excitement or, rather, there could be a lot of doubts around it. We complete a diversity of tests and cleaning trials to be confident that we have enough data to support our claims and theses. I did a TED talk, I think it was in 2017, speaking about laser-based drug delivery technology, and you can see there are mixed positions in terms of the reviews of it. People are doubtful because they do not have any information to help them not to be doubtful. Moreover, there are a lot of tests that still will need to be run. Acquiring empirical laboratory data that can be given or other empirical clinical data that will be given to back up the device and the achievements of the device will reduce these doubts.

• Yeah, thank you. Also, the question is, can the patient perform this procedure - at home, or a person has to go to the clinic?

• So that's a crucial question. So for any of the devices, we are making, we want them to be as easy as possible to operate by anyone. We make our devices more accessible, and there is no need to have trained personnel. The patient can still use it or have a family member help them use a laser-based drug delivery device. This concept makes it easy to use for people with any qualifications and makes it more accessible to the general population.

• It sounds rational, so what are your struggles and obstacles in providing this to people?

• Yes, so traditional medicine is the first and foremost obstacle, especially in Africa. That's again because people are doubtful and conventional, any type of commercial product will help them compared to the traditional products that they have known for years, and that they have used for years. We need to break those barriers. But now, when it also comes to commercial products, you know that South Africa has not made a lot of medical devices in the country, most of our medical devices are got from abroad. Competing with the heavyweights that are known international companies is quite challenging. But otherwise, we can find ways of collaborating with the known brands, and, you know, maybe creating technology together. It is possible even have them help us to export the technology from South Africa because technologies made in the country will be cheaper than devices bought from outside. So if we can then help the outside companies to benefit from the technologies that we are making, we can then generate some income from that.

• Yeah, I suppose, even government may support such kinds of projects, like exporting to other countries and having income at the economic level. I think this technology opens a lot of windows to new opportunities
• As the finishing line, do you have some message to the community about your technology?

• Yeah, I would say it's effortless to doubt something because of the fear of the unknown. So my message would be for communities to be flexible enough to give every possible technology accredited by the regulatory bodies a chance. Not everything that comes out is fake or is less efficient. There are a lot of innovations and technological disruptions that will happen five years, ten years, and 20 years from now, and life will be different from how we know it. And if people don't take risks, we're not going to get anywhere.

• Thank you. It's a great message, I totally agree with you. It's really inspiring. Thank you for sharing information that maybe you even haven't shared with others. I appreciate your honesty and wish you achieve all your goals.

• You're very welcome. Thanks, Jean.